Care Of Diabetic Patients Research Articles

Who took care of patients with diabetes during the COVID-19-pandemic? A registry-based study

Abstract Background The rise of people with chronic diseases strains our healthcare system. Chronic disease management programs (CDMP) provide accessible care for patients with a chronic disease, aiming to prevent further development of the disease and avoid the need for (more costly and severe) hospital treatments. During the COVID-19 pandemic, CDMP provided at general practices (GP) for diabetic patients were downscaled. It remains unknown whether this downsizing led to increased care in other healthcare settings. We examined the changes in healthcare utilization by Dutch diabetic patients in 2020 and 2021 compared to 2019 regarding; 1) CDMP consultations, 2) hospital care for diabetes and 3) regular GP care. Methods In this retrospective observational study, data from electronic health records of GPs, participating in Nivel Primary Care Database, of 15,247 Dutch diabetic patients who were enrolled in CDMP, were linked to hospital claims data. Differences in healthcare utilization in 2020 and 2021 compared to 2019 were assessed quarterly using regression analyses. Results Results show that CDMP care was notably lower in 2020 and 2021, compared to 2019 (-35%). From Q1 2021 onwards, patients received more hospital care for diabetes (+13%) and regular GP care increased from Q3 2020 onwards (+14%). Compared to 2019, reduced CDMP contacts in 2020 were significantly associated (p = 0.001) with increased regular GP care in 2021. In the short-term, decreased CDMP in the first half of 2021 was significantly associated with increased regular GP care (p = 0.033) and hospital care (p = 0.037) in the second half of 2021. Conclusions Temporarily downscaling CDMP care during the COVID-19-pandemic was associated with increased hospital and regular GP care for diabetic patients. These findings contribute to making informed decisions regarding measures during future pandemics. Key messages • Chronic disease management programs at GPs appear to be effective in preventing disease exacerbations, and may help prevent (expensive) utilization of hospital care. • This research prompts further investigation into the desirability of CDMPs among patients, GPs, hospitals and policymakers, crucial for assessing undesirable healthcare shifts in diabetic patients.

Safety Profiles Related to Dosing Errors of Rapid-Acting Insulin Analogs: A Comparative Analysis Using the EudraVigilance Database.

Diabetes is a widespread condition that can lead to multiple and severe complications. Rapid-acting insulin analogs (RAIAs) and long-acting insulin analogs are prescribed for the effective management of diabetes. RAIAs are expected to be associated with a higher number of dosing errors because of their rapid onset, short duration of action, and the need for frequent dosing, compared to other insulin analogs. There are three approved RAIAs on the market: insulin lispro (LIS), insulin aspart (ASP), and insulin glulisine (GLU). The aim of this study is to evaluate the real-world evidence on dosing errors reported for RAIAs in EudraVigilance (EV), an established pharmacovigilance database, in comparison to other insulin analogs and human insulins. A descriptive analysis and a disproportionality analysis were conducted. ASP and LIS were associated with high percentages of adverse drug reactions (ADRs) (22% and 17%, respectively), with over 70% of the reports involving serious ADRs. A higher frequency of cardiac and eye disorder ADRs was observed for LIS compared with ASP and GLU. GLU showed a higher frequency of ADRs in the skin and subcutaneous tissue disorders category. LIS dosing errors accounted for 5% of the total number of cases, while dosing errors for ASP and GLU were less than 3%. The most frequently reported dosing errors involved improper dosing (49%). Although there were fewer dosing errors of RAIAs in comparison to other insulins, the severity of the potential outcome highlights the importance of precise dosing and timing. Improved the monitoring and reporting of these dosing errors could enhance diabetes patient care. Additionally, smart medical devices could improve therapeutic outcomes.

8152 Benefits of Inpatient Diabetes Management by a Specialized Diabetes Team

Abstract Disclosure: M. Bojarian: None. A. Ohri: None. C. Buettner: None. Background: Inpatient dysglycemia is associated with poor clinical outcomes such as prolonged length of stay (LOS), increased risk of ICU admission, and in-hospital mortality. The benefits of managing diabetic patients in the hospital with a dedicated diabetes team, as opposed to standard care on episodes of hypoglycemia or hyperglycemia, reduction in LOS, and 30-day readmission rates, remain uncertain. A potential confounder is the likelihood that patients receiving a diabetes consult may be sicker than those without a consult. Given the growing evidence supporting the role of specialized diabetes teams in improving care for diabetes patients, we sought to examine these benefits at our hospital. We plan to address confounding variables through propensity score matching. Objective: To assess whether diabetes patients experience reduced LOS, hypoglycemia, hyperglycemia, and 30-day readmission rates when managed by a specialized diabetes team compared to inpatients managed by a hospitalist team. Material and Methods: This quality improvement study compared LOS, hypoglycemia (glucose <70 mg/dL), hyperglycemia (glucose >180 mg/dL), and 30-day readmission rates in diabetes patients managed by a specialized diabetes team versus a hospitalist team at our hospital between June 2022 and December 2022. Results: 5676 patients with diabetes were admitted between June and December 2022 at our hospital, and a specialized diabetes team managed 417 patients (7.34%). In a preliminary analysis in which no propensity matching was performed yet, the 30-day readmission rate was significantly lower (87,16.6%) in patients who received a diabetes consult compared to patients who did not receive a diabetes consult (320,17.9%). The rate of hypoglycemia was higher (24.4%) in the specialized diabetes consult group than in the non-diabetes consults group (19.9%). Additionally, LOS was longer in patients with a specialized diabetes consult (7.1 vs. 3.1 days), and hyperglycemia (glucose >180 mg/dL) was more prevalent in the specialized diabetes consult group (78.9%) compared to the non-diabetes consult group (39.2%). Conclusion: In this retrospective analysis, patients managed by a specialized diabetes team showed lower readmission rates despite longer hospitalization and increased dysglycemic episodes. This could be attributed to sicker patients receiving diabetes consults, influencing dysglycemia rates. To account for such confounders, ongoing propensity score matching aims to provide a clearer understanding. Reduced readmission rates suggest improved care transitions, potentially resulting in significant cost savings for the healthcare system. Presentation: 6/1/2024

Granular Porous Nanofibrous Microspheres Enhance Cellular Infiltration for Diabetic Wound Healing.

Diabetic foot ulcers (DFUs) are a significant challenge in the clinical care of diabetic patients, often necessitating limb amputation and compromising the quality of life and life expectancy of this cohort. Minimally invasive therapies, such as modular scaffolds, are at the forefront of current DFU treatment, offering an efficient approach for administering therapeutics that accelerate tissue repair and regeneration. In this study, we report a facile method for fabricating granular nanofibrous microspheres (NMs) with predesigned structures and porosities. The proposed technology combines electrospinning and electrospraying to develop a therapeutic option for DFUs. Specifically, porous NMs were constructed using electrospun poly(lactic-co-glycolic acid) (PLGA):gelatin short nanofibers, followed by gelatin cross-linking. These NMs demonstrated enhanced cell adhesion to human dermal fibroblasts (HDF) during an in vitro cytocompatibility assessment. Notably, porous NMs displayed superior performance owing to their interconnected pores compared to nonporous NMs. Cell-laden NMs demonstrated higher Young's modulus values than NMs without loaded cells, suggesting improved material resiliency attributed to the reinforcement of cells and their secreted extracellular matrix. Dynamic injection studies on cell-laden NMs further elucidated their capacity to safeguard loaded cells under pressure. In addition, porous NMs promoted host cell infiltration, neovascularization, and re-epithelialization in a diabetic mouse wound model, signifying their effectiveness in healing diabetic wounds. Taken together, porous NMs hold significant potential as minimally invasive, injectable treatments that effectively promote tissue integration and regeneration.

Blue Index as a Comprehensive, Patient-centered Assessment of Care in Diabetic Patients.

Assessment of diabetes health takes into account metabolic, nonmetabolic, and self-care measures like diet, exercise, follow-up, and habits. On the other hand, the index of complications includes the macro- and microvascular complications of diabetes along with foot complications. The Blue Index (BI) is a composite assessment of both diabetic health-related parameters and systemic complications stemming from diabetes. The present study aimed to evaluate the diabetes control status of the patients as a single index. A prospective, observational study included a total of 100 adult diabetic patients in whom diabetic health status (DHS) and Komplications Score (KS) were assessed for cardiovascular/macrovascular, microvascular, and foot complications. The BI was calculated as a composite ratio, and measures were obtained at baseline, after 3 months, and at 6 months. Data were statistically analyzed. Diabetic health status significantly increased at the 3rd month and the 6th month, respectively, compared to baseline (p = 0.000). KS significantly decreased at the 3rd month and the 6th month, respectively, compared to baseline measures (p = 0.000). The composite BI scores showed a steady increase of 9.62 at the 3rd month and 13.14 at the 6th month, respectively, compared to baseline. Assessing based on the duration of diabetes detection, the scores of DHS, KS, and BI showed similar changes. Assessing based on patients' gender, DHS was significantly higher in females at baseline compared to males, with gradual improvement in scores over time for both genders. Contrastingly, KS was significantly lower in males compared to females, with scores showing gradual decrement over the time frame, signifying improvement in complications. DHS was significantly correlated with the duration of diabetes detection (p = 0.001) and age (p = 0.01). The BI is a simple tool that incorporates various parameters covering different aspects of diabetes care, including complications. It may be used not only by endocrinologists but also by all physicians as a tool to monitor and improve diabetic care.

Why is it necessary to screen for periodontal disease in diabetic patients?

Periodontal diseases include gingivitis (inflammation of gingiva caused by the bacterial biofilm) and periodontitis involving loss of the supporting structures around the teeth, respectively cementum, periodontal ligament and alveolar bone. Diabetes increases the risk of periodontal diseases; the plausible mechanisms are: alterations in the immunoinflammatory response of bacteria, increased bone loss, the decrease in matrix-producing cells to maintain the periodontium, microvascular changes and alteration in collagen synthesis and metabolism. Treatment of periodontitis influence glycemic control in diabetic patients and intervention trial suggests that this can generate a reduction of circulating inflammatory markers and improves metabolic control in diabetic patients. International forums recommend oral examination as a component of medical care for diabetic patients. Our review summarizes current information on the association of diabetes with periodontal disease.

An automated approach to predict diabetic patients using KNN imputation and effective data mining techniques

Diabetes is thought to be the most common illness in underdeveloped nations. Early detection and competent medical care are crucial steps in reducing the effects of diabetes. Examining the signs associated with diabetes is one of the most effective ways to identify the condition. The problem of missing data is not very well investigated in existing works. In addition, existing studies on diabetes detection lack accuracy and robustness. The available datasets frequently contain missing information for the automated detection of diabetes, which might negatively impact machine learning model performance. This work suggests an automated diabetes prediction method that achieves high accuracy and effectively manages missing variables in order to address this problem. The proposed strategy employs a stacked ensemble voting classifier model with three machine learning models. and a KNN Imputer to handle missing values. Using the KNN imputer, the suggested model performs exceptionally well, with accuracy, precision, recall, F1 score, and MCC of 98.59%, 99.26%, 99.75%, 99.45%, and 99.24%, respectively. In two scenarios one with missing values eliminated and the other with KNN imputer, the study thoroughly compared the suggested model with seven other machine learning techniques. The outcomes demonstrate the superiority of the suggested model over current state-of-the-art methods and confirm its efficacy. This work demonstrates the capability of KNN imputer and looks at the problem of missing values for diabetes detection. Medical professionals can utilize the results to improve care for diabetes patients and discover problems early.

Effects of Pharmacist-Led Interventions Regarding Adult Patients with Type 2 Diabetes Mellitus in Mexico: A Systematic Review.

In Mexico, type 2 diabetes mellitus (T2DM) is a serious public health concern. As experts in drug therapy, pharmacists are essential additions to multidisciplinary diabetes patient care teams. There have been no systematic reviews or meta-analyses performed on pharmacist-led interventions (PIs) in Mexico; therefore, the impact of PIs on patients remains poorly explored. An electronic search of the PubMed, SciELO and BVS databases and certain institutional repositories was conducted in English and Spanish through 24 August 2021 with a subsequent update through June 2024. A total of 1302 potentially relevant studies were identified in the initial search, of which nine met the eligibility criteria and were included in this systematic review. The results suggest that PIs, such as pharmacotherapeutic follow-up and patient education, may have positive effects on outcomes in Mexican patients with T2DM. PIs led to significant reductions in glycosylated hemoglobin, fasting blood glucose, triglycerides, total cholesterol, LDL cholesterol and arterial blood pressure levels, general reductions in body mass index and negative outcomes associated with medication, as well as significant improvements in therapeutic adherence and patient knowledge in the intervention group during follow-up periods of 3-12 months. Further well-designed research, including controlled studies with adequate sample sizes and standardized tools, is essential to fully understand the effects of PIs regarding patients with T2DM in Mexico.

Impact of diabetes mellitus on endodontic treatment outcomes

Diabetes mellitus (DM) is a chronic metabolic disorder that affects various systemic functions, including oral health. Its impact on endodontic treatment outcomes has become a significant concern for dental practitioners. The relationship between DM and endodontic outcomes is complex, involving several pathophysiological mechanisms. Hyperglycemia leads to the formation of advanced glycation end-products, causing vascular dysfunction and impaired blood supply to the pulp, which exacerbates pulpal inflammation and increases the risk of necrosis. Additionally, chronic low-grade inflammation and an impaired immune response in diabetic patients contribute to a higher susceptibility to infections, delayed healing, and compromised tissue repair after endodontic procedures. Diabetic patients often experience lower success rates and prolonged recovery following endodontic treatment due to these systemic challenges. Reduced bone healing, persistent periapical lesions, and altered microbial flora are common complications that can hinder treatment success. Effective management of endodontic treatment in diabetic patients requires a multifaceted approach that includes strict glycemic control, the use of enhanced antimicrobial strategies, and the adoption of minimally invasive techniques to reduce tissue trauma. Additionally, patient education and close monitoring of the healing process are essential for minimizing complications. Understanding the pathophysiological interactions between diabetes and pulpal inflammation, as well as the factors that influence healing and success rates, is crucial for optimizing endodontic care in diabetic patients. By addressing both systemic and local factors, dental practitioners can improve the prognosis of endodontic treatment and ensure better outcomes for patients with diabetes. Ongoing research into the mechanisms underlying these complications will further enhance the ability of clinicians to manage endodontic cases effectively in this growing patient population.

Barriers to Accessing Health Care for Patients Living in Poverty: A Qualitative Study of Diabetic Patients in Morocco

Background: Poverty has been identified as a significant barrier to access to care for diabetes patients. Diabetes requires ongoing and adequate medical care, and delays or lack of care can exacerbate the disease and its complications. Objectives: The aim of this study was to explore the barriers that affect access to healthcare among diabetic patients living in poverty in Morocco. Methods: A qualitative study was conducted with 20 diabetic individuals selected through purposive sampling. An interview guide was developed to facilitate in-depth interviews. The data were evaluated using the qualitative content analysis method. Results: Following data saturation, the final sample consisted of 20 participants: Twelve males and eight females, ranging in age from 23 to 83 years old. Three themes were identified as barriers for the poor: Contextual barriers, healthcare institution barriers, and patient barriers. The main findings highlighted the financial difficulties patients face due to the high cost of treatment for their illnesses. There was also an emphasis on issues related to healthcare institutions, including a lack of equipment and medication, staff shortages, distance, transportation, and the nature of the relationship between healthcare providers and patients. Conclusions: The study examined the obstacles to obtaining healthcare for diabetic patients living in poverty. These findings will help generate realistic recommendations for new strategies to improve equitable access to healthcare for the poor.

Economic Evaluation of Fasting Mimicking Diet vs Standard Care in Diabetic Patients on Dual or Triple Medications at Baseline in the United States: A Cost-Utility Analysis

ObjectivesAccording to most guidelines, dietary interventions are essential in the management of diabetes. Fasting has emerged as potential therapeutic regimes for diabetes. The proof-of-concept study and the fasting in diabetes treatment trial are the first to explore the clinical impact of the Fasting Mimicking Diet (FMD) in patients with type 2 diabetes mellitus. Their results showed that FMD cycles improve glycemic management and can be integrated into usual care complementary to current guidelines. This economic evaluation aims to assess the 10-year quality-of-life effects, cost implications, and cost-effectiveness of adding a 3-year FMD program to diabetes standard care in diabetic population on dual or triple medications at baseline from the perspective of the US payer. MethodsWe constructed a microsimulation model in TreeAge using a published US-specific diabetes model. The model was populated using FMD effectiveness outcomes and publicly available clinical and economic data associated with diabetes complications, use of diabetes medications, hypoglycemia incidence, direct medical costs in 2021 USD, quality of life, and mortality. All benefits were discounted by 3%. ResultsThis cost-utility analysis showed that the FMD program was associated with 11.4% less diabetes complications, 67.2% less overall diabetes medication use, and 45.0% less hypoglycemia events over the 10-year simulation period. The program generated an additional effectiveness benefit of 0.211 quality-adjusted life year and net monetary benefit of 41 613 USD per simulated patient. Thus, the FMD program is cost saving. ConclusionsThese results indicate that the FMD program is a beneficial first-line strategy in T2DM management.

Effects of Monochromatic Infrared Light on Painful Diabetic Polyneuropathy: Randomized Controlled Trial

Purpose: To evaluate the effect of 890 nm Monochromatic Infrared Light (MIR) associated with a physical therapy protocol on pain in individuals with diabetic Distal Symmetric Polyneuropathy.Methods: Randomized, parallel, double-blind controlled trial conducted with individuals randomly allocated into two groups: an experimental group (EG) with the application of 890 nm MIR associated with physical therapy and a control group that received the same treatment protocol without MIR application. Both groups underwent 18 treatment sessions and were followed up for 10 weeks. Pain assessment took place at four times using the instruments: Leeds Assessment of Neuropathic Symptoms and Signs, Douleur Neuropathique 4, and Brief Pain Inventory. Descriptive, inferential statistics and probabilistic estimates of the magnitude of the intervention's effect on neuropathic pain were used in data analysis (5% significance level).Results: A total of 144 patients were allocated to groups. Lower levels of pain were observed for the EG after 6 weeks of intervention (p < .001) and 30 days after the intervention ended (p < .001). Pain intensity was lower and sleep quality improved (p < .001) for the experiment group, especially in people with severe pain.Conclusions: 890 nm MIR associated with a physical therapy protocol alleviated pain in people with Diabetic Painful Polyneuropathy after 6 weeks of follow-up, showing to be a promising alternative for the control of neuropathic pain due to diabetes mellitus.Clinical Implications: 890 nm MIR improves Painful Diabetic Polyneuropathy patient care due to relief of neuropathic pain.

Challenges in Biofilm Identification in Diabetic Foot Infections: Review of Literature.

Foot ulcerations are one of the most common complications of diabetes and one of the major initial causes of amputations. The formation of biofilms on wounds significantly contributes to infections and delayed healing. While existing methods for identifying these biofilms have limitations, there is a need for a convenient tool for its clinical application. This literature review aimed to address the problem with current clinical biofilm identification in wound care and a proposal for biofilm-detection-based wound care in diabetic foot ulcer patients. Identifying biofilms is particularly vital due to the absence of typical signs of infection in DFUs. However, current approaches, although effective, often prove invasive and technically intricate. The wound blotting technique, involving attaching a nitrocellulose membrane and subsequent staining, presents an alternative that is swift and non-invasive. Research highlights the applicability of wound blotting with alcian blue staining in clinical scenarios, consistently producing sensitive outcomes. By addressing the critical need for early biofilm detection, wound blotting holds promise for enhancing DFU management and contributing to strategies aimed at preventing amputations.

Comparative analysis of semantic segmentation and multi-boosted faster R-CNN for robotic tool detection in diabetes patient care

Diabetes, a common chronic illness, need meticulous patient care and treatment, which frequently necessitates advanced robotic help. The identification of robotic tools is critical in guaranteeing precise and safe medical procedures. With the growing use of robots in healthcare, reliable identification of instruments inside a patient care setting is critical for allowing smooth and efficient medical procedures. We used a Multi-Boosted Faster-Region-based Convolutional Neural Network (MBF-RCNN) to estimate Robotic Tool Detection in Diabetes Patient Care in the present research. Semantic Segmentation is a machine learning methodology centered on classifying pictures pixel-by-pixel, whereas Multi-Boosted Faster R-CNN recognizes objects using a variety of boosting strategies. Decimal Scaling Normalization is used during the preprocessing step to optimize the input data for both procedures. The effectiveness of both approaches is improved by doing extraction of features using Linear Discriminant Analysis (LDA) to find key trends in the information that is provided.The Multi-Boosted Faster-Region-based Convolutional Neural Network (MBF-RCNN) is an improved variation of the Faster R-CNN design that uses the boosting approach to improve object identification performance.Accuracy, Precision, Recall, F1-score, and the Receiver Operating Characteristic (ROC) curve among the assessment metrics used. The findings show that the suggested approaches are effective in identifying and localizing robotic equipment, which is critical for effective treatments in controlling diabetes.This research promotes computer vision applications in healthcare, particularly in the care of diabetic patients. It assesses the efficiency and dependability of Semantic Segmentation and MBF-RCNN for robotic tool identification, opening the way for more efficient and dependable automation for healthcare contexts.

The role of depth of general anesthesia in serum CGRP and SP level in diabetes patients.

Diabetes, which is associated with cardiovascular disease and related microvascular complications, affects life expectancy and decrease quality of life. A trial reports that the risk of patients with diabetes having cardiovascular disease is 2-4 times compared with that in patients without diabetes. This study aims to investigate the relationship between depth of general anesthesia in patients with diabetes mellitus. This clinical study totally includes 40 patients with diabetes mellitus, and these patients are divided into following two groups: diabetes mellitus deep anesthesia group and diabetes mellitus light anesthesia group, and then these patients receive general anesthesia combined with laparoscopic surgery. Preoperative patient general data and intraoperative patient general data are collected and analyzed. Calcitonin gene-related peptide (CGRP) and substance P (SP) level are determined by Enzyme-linked immunosorbent assay (ELISA). This study included a total of 40 patients. There were no significant differences in demographic and preoperative patient general data between the two groups. Measurements were taken for operative time, anesthesia time, recovery time after drug withdrawal, dwell time in the recovery room, intraoperative fluid volume, intraoperative blood loss, and intraoperative urine output between the two groups. Significant differences were observed in the recovery time after drug withdrawal between the two groups. CGRP and SP level in diabetes mellitus deep anesthesia group are evidently more than those in diabetes mellitus light anesthesia group. CGRP and SP level are involved in the diabetes mellitus and up-regulated CGRP and SP can prevent the development of diabetes mellitus. Our study extends the existing literature by addressing a gap in knowledge regarding the impact of anesthesia depth on neuropeptide levels in diabetes mellitus patients. By delineating this relationship, we aim to contribute to the advancement of perioperative care practices and ultimately improve outcomes for individuals with diabetes undergoing surgical procedures. Our study's findings provide valuable insights into the complex interactions between anesthesia, neuropeptides, and diabetes mellitus, offering the potential for personalized perioperative care, enhanced pain management, and improved surgical outcomes. These implications highlight the clinical relevance of our research and its potential to inform future advancements in perioperative care for diabetic patients undergoing surgery.

Heterogeneous CuxO Nano-Skeletons from Waste Electronics for Enhanced Glucose Detection

HighlightsNovel laser-induced transfer method for fabricating glucose sensors from recycled e-waste copper, offering a sustainable and cost-effective solution.Unique heterogeneous CuxO nano-skeletons derived from discarded printed circuit boards exhibiting exceptional glucose-sensing performance (sensitivity: 9.893 mA mM−1 cm−2, detection limit: 0.34 μM).Miniaturized glucose detection device, optimized for scalability and portability, revolutionizing diabetes management and patient care.

Observation of the effectiveness of high-quality nursing services in the care of diabetic patients in the ICU.

Observation of the effectiveness of high-quality nursing services in the care of diabetic patients in the ICU.

Alternative Health Care among Type 2 Diabetes in ASEAN Countries: A Scoping Review

Introduction: The prevalent rate of diabetes is increasing among the world and ASEAN countries itself. The treatment using alternative health care (AHC) is one of exist medication among diabetes patients. In addition, the evidence on the management of diabetes through the use of traditional medicine has not been addressed before. Objective: The purpose of this scoping review was to review and summarize the AHC therapies in literature that are the most well-known and successful for glycemic control complication and the burden among diabetes patients in ASEAN countries. Methods: To access all studies and articles related to the scoping review’s aim, seven databases were searched. The seven data based included PubMed, ProQuest, ScienceDirect, SCOPUS, Google Scholar, the Cochrane Library, and CINAHL unlimited until August 12, 2023. The search method used keywords “diabetes”, “alternative health care”, “ASEAN” and “Indonesia”, modifying the search statements of these phrases so that they were compatible with the various databases. Results: The result of study after critical appraisal using JBI critical appraisal checklist for RCT were found three kinds of alternative health care for diabetes patients, first herbs or traditional medication which are herbal extract of cinnamon bark powder 3%, pandan leaf 6%, and bay leaf 9% and herbs extract of breadfruit life, second community care, there is CIIC (Community Integrated Intermediary Care), and third, mind and body therapies such as acupuncture, acupressure and message. Conclusion: The utilization of AHC (Alternative Health Care) has demonstrated its efficacy in the management of diabetes, leading to enhanced clinical outcomes and a decrease in both blood glucose levels and associated burdens. Despite the scarcity of empirical data, it is widely acknowledged that the recommended therapeutic interventions yield advantages in inducing relaxation, which subsequently contributes to the alleviation of stress.

1820-LB: Evaluating an HCP Diabetes Training Program in Kasese, Uganda

Introduction &amp; Objective: Health Care Provider (HCP) diabetes educational sessions are core to the mission of Diabetes Empowerment International (DEInt) in Kasese, Uganda. Understanding HCP profiles and their barriers to diabetes education access is essential to shape a successful training program. We evaluated the profile of the HCPs that are trained as well as the feedback received regarding how the training is implemented in patient care. Methods: In person HCP diabetes seminars are held every 8 weeks DCA/DEINt Diabetes Education Center in Kasese, covering a curriculum of key topics related to care of diabetes. Each session hosts over 50 regional HCPs, and over 106 HCPs have attended 23 education seminars. Participant evaluations are performed for each seminar for impact on diabetes knowledge and patient care. Results: The average distance traveled for the conferences was 29.4 km [range 0.5-63.2 km]. The majority of participants are enrolled nurses (n=51, 48.11 %), followed by assistant nursing officers (n=20, 18.87 %), and enrolled midwives (n=11, 10.38 %). The remainder of participants have varied healthcare provider titles. The majority of HCPs reported that there was a diabetes trained doctor in the facility where they worked (n=62, 58.49 %). The mean number of diabetes patients supported was 40 [range 0-418]. A total of 8,733 people with diabetes are being served by the HCPs with 289 type 1 diabetes patients and 770 type 2 diabetes patients. The topics that attendees expressed the most confidence in managing patients with diabetes was checking blood sugars and hypoglycemia. Topics that attendees indicated that they would change how they treat diabetes patients was insulin pumps (n=55, 62.5%) and carbohydrate counting (n=54, 61.36 %). Conclusion: Our diabetes training programs supports a wide range of HCPs. HCP diabetes training can have a far-reaching impact on an underserved population of individuals with diabetes. Disclosure S. Narayanan: Employee; Dexcom, Inc. C. Basch: None. J. Baker: Speaker's Bureau; Insulet Corporation, Dexcom, Inc., Sanofi.

560-P: Optimizing Vision Care for Diabetes Patients—Interprofessional Initiatives to Combat Clinical Inertia in the Management of Diabetic Retinopathy and Diabetic Macular Edema

560-P: Optimizing Vision Care for Diabetes Patients—Interprofessional Initiatives to Combat Clinical Inertia in the Management of Diabetic Retinopathy and Diabetic Macular Edema